加味宣白承气汤治疗重症肺炎合并急性胃肠损伤的临床研究

目的 评价加味宣白承气汤治疗重症肺炎合并急性胃肠损伤(Acute gastrointestinal injury,AGI)的临床疗效.方法 采用随机对照研究,将76例重症肺炎合并AGI住院患者随机分成对照组和治疗组各38例,对照组给予西医常规治疗,包括积极治疗原发病和合并疾病、尽早给予肠内营养、胃肠动力药等,治疗组在对...

Clinical Study on the Treatment of Severe Pneumonia Combined with Acute Gastrointestinal Injury by Supplemented Xuanbai Chengqi Decoction

OBJECTIVE To evaluate the clinical efficacy of Supplemented Xuanbai Chengqi Decoction in the treatment of severe pneumonia combined with acute gastrointestinal injury(AGI).METHODS In a randomized controlled study,76 patients with severe pneumonia combined with AGI were randomly divided into the control group and the treatment group,38 patients in each group.The control group was given conventional western medical treatment,including active treatment of protopathy and complicating disease.In addition,early administration of enteral nutrition and gastrointestinal excitomotor were given in the group.The patients in the treatment group were treated with supplemented Xuanbai Chengqi Decoction intranasally on top of the treatments in the control group.The course of treatment was 7 days and the clinical efficacy of the two groups was evaluated before treatment and 7 days after treatment.The changes of gastrointestinal function indexesGastrointestinal failure(GIF)score,enteral nutrition daily feeding amount and intraabdominal pressure(IAP)]were measured before treatment,3 and 7 days after the treatment separately.Motilin(MTL)levels and diamine oxidase(DAO)activity were measured by ELISA.Besides,the duration of mechanical ventilation,ICU stay length and 28-d mortality rate were recorded.RESULTS After treatment,the total effective rate of the treatment group was better than that of the control group(P<0.05).The GIF,enteral nutrition daily feeding amount and IAP of the treatment group significantly improved(P<0.01).However,the GIF,enteral nutrition daily feeding amount and IAP of the treatment group showed better results than those of the control group after 7 days of treatment(P<0.05).In addition,the serum MTL level and DAO activity were significantly increased in both groups after 3 and 7 days of treatment(P<0.01).However,the MTL levels in the treatment group were significantly higher than those in the control group after 3 and 7 days of treatment(P<0.05,P<0.01).The duration of mechanical ventilation and ICU stay length in the treatment group were significantly less than those in the control group(P<0.01).Besides,there was no significant difference in the 28-d mortality rate between the two groups(P>0.05).CONCLUSION Supplemented Xuanbai Chengqi Decoction can effectively improve the gastrointestinal function of patients with severe pneumonia combined with AGI,shorten the ICU stay length,and promote the recovery of patients.